Deck 11: Eyes

Question 1

A pregnant woman in her third trimester tells you that her vision has been a little blurred and she thinks she needs to get new contact lenses. You should advise her to

A)get new lenses as soon as possible to avoid complications.
B)wait until several weeks after delivery to get new lenses.
C)go to the nearest emergency department for evaluation.
D)change her diet to include more yellow vegetables.
E)decrease her water intake.

Answer 1

wait until several weeks after delivery to get new lenses.

Question 2

A Rosenbaum card is used to measure

A)distance perception.
B)near vision.
C)peripheral distortion.
D)the ability to identify colors.
E)extraocular movements.

Answer 2

near vision.

Question 3

Tears flow over the cornea and drain via the lacrimal sac into the

A)lacrimal gland.
B)posterior pharynx.
C)nasal meatus.
D)thyroglossal duct.
E)anterior fossa.

Answer 3

nasal meatus.

Question 4

Contraction or relaxation of the ciliary body

A)allows voluntary blinking.
B)changes lens thickness.
C)regulates peripheral vision.
D)sends light impulses to the brain.
E)regulates tear production.

Question 5

Mr. C's visual acuity is 20/50. This means that he

A)can see 50% of what the average person sees at 20 feet.
B)has perfect vision when tested at 50 feet.
C)can see 20% of the letters on the chart's 20/50 line.
D)can read letters while standing 20 feet from the chart that the average person could read at 50 feet.
E)is legally blind.

Question 6

At what age does an infant usually develop the ability to distinguish color?

A)At birth
B)2 months
C)6 months
D)12 months
E)16 months

Question 7

Term infants have a visual acuity of about

A)20/20.
B)20/100.
C)20/200.
D)20/300.
E)20/400.

Question 8

The criterion for adequacy of a patient's visual field is

A)the ability to discriminate primary colors.
B)the ability to discriminate details.
C)correspondence with the visual field of the examiner.
D)distance vision equal to that of an average person.
E)pupillary constriction when an object is moved close to the nose.

Question 9

Which of the following is a genetic eye disorder that should be included in the history and physical examination, under family history, for all members of the affected family?

A)Constrictive iritis
B)Retinoblastoma
C)Oval pupils
D)Retinal hemorrhages
E)Maculates

Question 10

The sensory network of the eye is the

A)cornea.
B)iris.
C)pupil.
D)retina.
E)vitreous body.

Question 11

Which of the following findings, when seen in an infant, is most ominous?

A)Difficulty tracking objects with the eyes
B)Appearing to have better peripheral than central vision
C)Blinking when bright light is directed at face
D)White pupils on photographs
E)The appearance of convergence

Question 12

Measurement of near vision should be tested

A)in each eye separately.
B)with the head at a 45-degree angle.
C)with the use of primary colors.
D)using the Snellen chart.
E)with the confrontation test.

Question 13

When does the lens usually become more rigid and the ciliary muscle of the iris become weaker?

A)Adolescence
B)Around 25 years of age
C)Around 35 years of age
D)Around 45 years of age
E)Older than 65 years of age

Question 14

Contraction of which eye structure controls the amount of light that reaches the retina?

A)Retina
B)Medial rectus muscle
C)Sclera
D)Lens
E)Iris

Question 15

A structure that protects the eye from foreign bodies is the

A)conjunctiva.
B)cornea.
C)eyelid.
D)sclera.
E)lens.

Question 16

An increased level of lysozyme in the tears will occur normally during which life stage?

A)Adolescence
B)Childhood
C)Infancy
D)Pregnancy
E)Older adults

Question 17

Peripheral vision can be estimated by means of which test?

A)Confrontation
B)Pupillary reaction
C)Accommodation
D)Snellen E chart
E)Swinging flashlight

Question 18

A condition that typically develops by the age of 45 years is

A)presbyopia.
B)hyperopia.
C)myopia.
D)astigmatism.
E)cataracts.

Question 19

When measuring visual acuity, you are assessing cranial nerve

A)I.
B)II.
C)IV.
D)VI.
E)VIII.

Question 20

Which of the following is a relatively benign condition that may occur during pregnancy or labor?

A)Macular degeneration
B)Papilledema
C)Subconjunctival hemorrhage
D)Cupping of the optic disc
E)Presbyopia

Question 21

Xanthelasma may suggest that the patient has an abnormality of

A)lipid metabolism.
B)cognitive function.
C)renal metabolism.
D)bone marrow function.
E)thyroid disease.

Question 22

When inspecting the region of the lacrimal gland, palpate

A)the lower orbital rim near the inner canthus.
B)in the area between the arch of the eyebrow and the upper eyelid.
C)beneath the lower eyelid adjacent to the inner canthus.
D)adjacent to the lateral aspect of the eye, just beneath the upper eyelid.
E)medially above the eyebrow.

Question 23

An abnormal growth of conjunctiva extending over the cornea from the limbus is known as

A)a cataract.
B)erythematous.
C)glaucoma.
D)conjunctivitis.
E)a pterygium.

Question 24

When testing corneal sensitivity controlled by cranial nerve V, you should expect the patient to respond by

A)blinking.
B)copious tearing.
C)pupil dilation.
D)reflex smiling.
E)pupil constriction.

Question 25

Entropion implies that the eyelid is

A)drooping.
B)everted.
C)edematous.
D)turned inward.
E)inflamed.

Question 26

When there is an imbalance found with the corneal light test, you should then perform the _____ test.

A)confrontation
B)accommodation
C)cover-uncover
D)visual acuity
E)pupillary light reflex

Question 27

An inequality of pupillary size is called

A)hyperopia.
B)diopter.
C)ptosis.
D)anisocoria.
E)mydriasis.

Question 28

Ptosis may be secondary to

A)blepharitis.
B)hyperthyroidism.
C)psoriasis.
D)paresis of a branch of cranial nerve III.
E)entropion.

Question 29

A pterygium is more common in people heavily exposed to

A)high altitudes.
B)tuberculosis.
C)ultraviolet light.
D)cigarette smoke.
E)lead.

Question 30

You note a dark, slate gray pigment just anterior to the insertion of the medial rectus muscle in an 80-year-old woman. Which action is appropriate?

A)Record the finding in the patient's record.
B)Refer the patient to an ophthalmologist.
C)Attribute the finding to type II hyperlipidemia.
D)Ask the patient if she remembers being hit in the eye.
E)Test the patient immediately for liver disease.

Question 31

Inspection of the tarsal conjunctiva should be performed

A)with every eye examination.
B)in eye examinations in patients older than 45 years of age.
C)when a foreign body may be present.
D)for the patient with glaucoma.
E)with the patient looking upward.

Question 32

Periorbital edema is

A)an abnormal sign.
B)expected with aging.
C)more common in males.
D)present in children.
E)an abnormality of lipid metabolism.

Question 33

An examination to assess for extraocular muscle imbalance is conducted by

A)comparing pupillary responses to different shapes.
B)everting the upper and lower eyelids.
C)inspecting slightly closed lids for fasciculations.
D)transilluminating the cornea with tangential light.
E)having the patient follow your finger through different planes.

Question 34

Mr. B was admitted from the emergency department, and you are completing his physical examination. His pupils are 2 mm bilaterally, and you notice that they fail to dilate when the penlight is moved away. This is characteristic in patients who are or have been

A)in a coma.
B)taking sympathomimetic drugs (e.g., cocaine).
C)taking opioid drugs (e.g., morphine).
D)treated for head trauma.
E)atropine overdosed.

Question 35

What is the condition called when the eyelid is turned away, or everted, from the globe?

A)Ectropion
B)Entropion
C)Exophthalmos
D)Ptosis
E)Acute hordeolum

Question 36

Mrs. S. is a 69-year-old woman who presents for a physical examination. On inspection of her eyes, you note that the left upper eyelid droops, covering more of the iris than does the right. This is recorded as _____ on the _____.

A)exophthalmos; left
B)ptosis; left
C)nystagmus; left
D)astigmatism; right
E)ectropion; left

Question 37

You observe a pupillary response as the patient looks at a distant object and then at an object held 10 cm from the bridge of the nose. You are assessing for

A)confrontation reaction.
B)accommodation.
C)pupillary light reflex.
D)nystagmus.
E)corneal circus senilis.

Question 38

A condition in which the eyelids do not completely meet to cover the globe is called

A)glaucoma.
B)lagophthalmos.
C)exophthalmos.
D)hordeolum.
E)blepharitis.

Question 39

An allergy can cause the conjunctiva to have a

A)cobblestone pattern.
B)dry surface.
C)subconjunctival hemorrhage.
D)rust-colored pigment.
E)pale appearance.

Question 40

Mydriasis accompanies

A)coma.
B)diabetes.
C)hyperopia.
D)astigmatism.
E)morphine administration.

Question 41

The Snellen E chart is appropriate for initial visual acuity in a child of which age?

A)Newborn
B)6 months
C)18 months
D)3 years
E)8 years

Question 42

If a patient has early papilledema, the examiner will be able to detect

A)dilated retinal veins.
B)retinal vein pulsations.
C)sharply defined optic discs.
D)visual defects.
E)narrowed retinal veins.

Question 43

To differentiate between infants who have strabismus and those who have pseudostrabismus, use the

A)confrontation test.
B)corneal light reflex.
C)E chart.
D)Amsler grid.
E)cover-uncover test.

Question 44

White specks scattered in a linear pattern around the entire circumference of the iris are called

A)drusen bodies.
B)cotton wool spots.
C)rust spots.
D)Brushfield spots.
E)band keratopathy.

Question 45

After focusing on a blood vessel in the retina with your ophthalmoscope, you attempt to locate the optic disc. You should

A)follow the vessel as it branches out.
B)have the patient move his or her eye laterally.
C)have the patient move his or her eye up.
D)have the patient move his or her eye down.
E)follow the vessel as it converges into larger vessels.

Question 46

You are attempting to examine the eyes of a newborn. To facilitate eye opening, you would first

A)dim the room lights.
B)elicit pain.
C)place the newborn in the supine position.
D)shine the penlight in the newborn's eyes.
E)apply mydriatics.

Question 47

After completion of your ophthalmoscopic examination, you record that the arteriole-to-venule ratio is 1:2 This indicates that the

A)arterioles are narrowed.
B)venules are narrowed.
C)ratio is normal for a child.
D)ratio is normal for an adult.
E)arterioles are dilated.

Question 48

The unit of measurement in describing lesion size and location on the fundus is the

A)disc diameter.
B)macular diameter.
C)pupillary diameter.
D)centimeter.
E)diopter.

Question 49

What maneuver can be done to reduce the systemic absorption of cycloplegic and mydriatic agents when examining a pregnant woman if the examination is mandatory?

A)Have the woman keep her eyes closed for several minutes.
B)Instill half the usual dosage.
C)Keep the patient supine.
D)Use nasolacrimal occlusion after instillation.
E)Have the patient keep her head turned and flexed.

Question 50

Cupping of the optic disc may be a result of

A)migraine headaches.
B)diabetes.
C)glaucoma.
D)dehydration.
E)cataracts.

Question 51

Which of the following may be suggestive of Down syndrome?

A)Drusen bodies
B)Papilledema
C)Narrow palpebral fissures
D)Prominent epicanthal folds
E)Entropion

Question 52

To see retinal details in a patient with myopia, the examiner will need to

A)adjust the ophthalmoscope into the plus lenses.
B)move the ophthalmoscope backward.
C)move the hand farther forward.
D)examine the patient in a well-lighted room.
E)turn the ophthalmoscope to a minus lens.

Question 53

Cotton wool spots are most closely associated with

A)glaucoma.
B)normal aging processes.
C)hypertension.
D)eye trauma.
E)hyperthyroidism.

Question 54

The Keith-Wagner-Barker system group IV is characterized by the development of

A)an increased light reflex in the arterioles.
B)crossing defects.
C)cotton wool spots.
D)papilledema.
E)retinal hemorrhages.

Question 55

You normally expect a child to achieve 20/20 vision by age ____ years.

A)3
B)4
C)5
D)6
E)8

Question 56

When drusen bodies are noted to be increasing in number or in intensity of color, the patient should be further evaluated with a(n)

A)Amsler grid.
B)Snellen E chart.
C)litmus test.
D)confrontation test.
E)Keith-Wagner-Barker (KWB) system.

Question 57

Episcleritis may indicate

A)lipid abnormalities.
B)an autoimmune disorder.
C)an anaphylactoid reaction.
D)severe anemia.
E)thyroid disease.

Question 58

Opacities of the red reflex may indicate the presence of

A)hypertension.
B)hydrocephalus.
C)cataracts.
D)myopia.
E)diabetes.

Question 59

Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the

A)retina.
B)lens.
C)retinal vessels.
D)macula.
E)optic disc.

Question 60

Drusen bodies are most commonly a consequence of

A)glaucoma.
B)aging.
C)presbyopia.
D)papilledema.
E)hypertension.

Question 61

The most common cause of exophthalmos is

A)Graves disease.
B)diabetes.
C)hypertension.
D)glaucoma.
E)Crohn disease.

Question 62

Dot hemorrhages, or microaneurysms, and the presence of hard and soft exudates are most commonly seen in

A)Down syndrome.
B)diabetic retinopathy.
C)systemic lupus.
D)glaucoma.
E)retinitis pigmentosa.

Question 63

Bone spicule pigmentation is a hallmark of

A)chorioretinal pigmentosa.
B)cytomegalovirus infection.
C)lipemia retinalis.
D)retinitis pigmentosa.
E)choroidal nevus.

Question 64

Horner syndrome is manifested by

A)proptosis and contralateral mydriasis.
B)excessive watering of the eyes.
C)blurring of vision when glucose levels fall.
D)ipsilateral miosis and mild ptosis.
E)band keratopathy and miosis.

Question 65

An initial sign of retinoblastoma in an infant is

A)the cat's eye reflex.
B)the red reflex.
C)the corneal light reflex.
D)the absence of a blink reflex.
E)Brushfield spots.

Question 66

Changes seen in proliferative diabetic retinopathy are the result of

A)anoxic stimulation.
B)macular damage.
C)papilledema.
D)minute hemorrhages.
E)chorioretinal scarring.

Question 67

Retinal hemorrhages in an infant require investigation for

A)retinoblastoma.
B)retrolental fibroplasia.
C)pituitary tumor.
D)child abuse.
E)strabismus.